Infectious diseases physicians, clinical microbiologists and hospital pharmacists tend to have a love–hate relationship with the antibiotic ceftriaxone and its stablemate cefotaxime. These potent third-generation cephalosporins have an important place in every Australian hospital formulary, and boast numerous entries in the current edition of Therapeutic guidelines: antibiotic (AG).1 Third-generation cephalosporins (3GCs) are the antibiotics of choice for several life-threatening infections including bacterial meningitis. They are convenient to administer and are among the safest antibiotics available. Yet, these drugs have become the bête noire of hospital epidemiologists. So, what's the problem?
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- 1. Therapeutic guidelines: antibiotic. 11th ed. Melbourne: Therapeutic Guidelines Limited, 2000.
- 2. Medeiros AA. Evolution and dissemination of beta-lactamases accelerated by generations of beta-lactam antibiotics. Clin Infect Dis 1997; 24: S19-S45.
- 3. Fridkin SK, Edwards JR, Courval JM, et al. The effect of vancomycin and third-generation cephalosporins on prevalence of vancomycin-resistant enterococci in 126 US adult intensive care units. Ann Intern Med 2001; 135: 175-183.
- 4. Saurina G, Quale JM, Manikal VM, et al. Antimicrobial resistance in Enterobacteriaceae in Brooklyn, NY: epidemiology and relation to antibiotic usage patterns. J Antimicrob Chemother 2000; 45: 895-898.
- 5. Rice LB. Successful interventions for gram-negative resistance to extended-spectrum beta-lactam antibiotics. Pharmacotherapy 1999; 19: 120S-128S.
- 6. McFarland LV, Surawicz CM, Stamm WE. Risk factors for Clostridium difficile carriage and C. difficile-associated diarrhea in a cohort of hospitalized patients. J Infect Dis 1990; 162: 678-684.
- 7. Collignon PJ, Turnidge JD. Antibiotic resistance in Streptococcus pneumoniae. In: Pneumococcal disease in Australia. Med J Aust 2000; 173 Suppl 2 October: S58-S64.
- 8. Landman D, Chockalingham M, Quale JM. Reduction in the incidence of methicillin-resistant Staphylococcus aureus and ceftazidime-resistant Klebsiella pneumoniae following changes in a hospital antibiotic formulary. Clin Infect Dis 1999; 28: 1062-1066.
- 9. Robertson MB, Korman TM, Dartnell JGA, et al. Ceftriaxone and cefotaxime use in Victorian hospitals. Med J Aust 2002; 176: 524-529. <eMJA Full text>
- 10. Andresen DN, Collignon PJ. Antibiotics for community-acquired pneumonia: time to return to the straight and narrow? Med J Aust 2001; 174: 321-322.
- 11. Centers for Disease Control. Campaign to prevent antimicrobial resistance in healthcare settings. <http://www.cdc.gov/drugresistance/healthcare/>.
- 12. Gross PA, Pujat D. Implementing practice guidelines for appropriate antimicrobial usage: a systematic review. Med Care 2001; 39(8 Suppl 2): II55-II69.
- 13. Misan GMH, executive editor. The Australian medicines handbook: AMH 2002. 3rd ed. Adelaide: Australian Medicines Handbook, 2002.
- 14. Wilcox RA, La Tella RR. The personal digital assistant: a new medical instrument for the exchange of clinical information at the point of care. Med J Aust 2001; 175: 659-662. <eMJA Full text>
- 15. Bradley SJ, Wilson AL, Allen MC, et al. The control of hyperendemic glycopeptide-resistant Enterococcus spp. on a haematology unit by changing antibiotic usage. J Antimicrob Chemother 1999; 43: 261-266.
- 16. Quale J, Landman D, Saurina G, et al. Manipulation of a hospital antimicrobial formulary to control an outbreak of vancomycin-resistant enterococci. Clin Infect Dis 1996; 23: 1020-1025.
- 17. Teich JM, Merchia PR, Schmiz JL, et al. Effects of computerized physician order entry on prescribing practices. Arch Intern Med 2000; 160: 2741-2747.
- 18. Robertson MB, Richards M, Dartnell JGA, et al. A web-based antibiotic approval system for ceftriaxone and cefotaxime at The Royal Melbourne Hospital [abstract]. In: Abstracts of the 25th Federal Conference of the Society of Hospital Pharmacists of Australia; Hobart, 2001. South Melbourne: Society of Hospital Pharmacists of Australia, 2001.
- 19. Grayson ML, Melvani S, Kirsa S, et al. Introduction of an infectious diseases electronic antibiotic advice and approval system (IDEA3S) [abstract]. In: Abstracts of the Annual Scientific Meeting of the Australasian Society for Infectious Diseases, Barossa Valley, 2002. Sydney: Australasian Society for Infectious Diseases, 2002.
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